The difference between lumbar disc herniation and bulging is that this is a different clinical typing of the disease.
To distinguish the difference between them should start from the understanding of the lumbar disc anatomy, lumbar intervertebral disc is mainly divided into the nucleus pulposus, annulus fibrosus and cartilage plate, the so-called “herniation” that is, as we age, lumbar spine degenerative changes, the intervertebral disc of the annulus fibrosus is ruptured, nucleus pulposus rupture protrudes (or prolapse) in the posterior or vertebral canal, stimulating the squeeze of the surrounding neighboring nerve roots, which in turn produces lumbar pain. This stimulates and squeezes the surrounding neighboring nerve roots, which in turn produces lumbar pain.
Clinically, the degree of nerve root compression by the nucleus pulposus is categorized into 4 types: bulging, herniated, prolapsed and free, and Schmorl’s nodes. This is the difference between lumbar disc herniation and bulging.
1. Bulging type: only part of the annulus fibrosus is ruptured, but the surface layer is still intact, which can be relieved by conservative treatment.
2. Protruding type: the annulus fibrosus is completely ruptured, the nucleus pulposus protrudes into the spinal canal and squeezes the nerve root. Conservative treatment can only alleviate the symptoms, and surgical treatment can achieve the effect of radical cure.
3. Prolapse type: the ruptured and protruded intervertebral disc tissue or fragments are dislodged into the spinal canal or completely dislodged. This type is often accompanied by abnormal sensation (pain, numbness, etc.) in the lower limbs. There are clear indications for surgery.
4. Schmorl’s nodes: The nucleus pulposus enters the cancellous bone of the vertebral body through the fissures in the cartilage of the upper and lower endplates. These patients only have low back pain, and most of them do not need surgical treatment.
Clinical lumbar disc herniation needs to be categorized by the clinician’s physical examination and imaging examination, please do not diagnose on your own, if the back pain persists without relief, please consult the doctor in time to avoid delaying the condition.